Carter BloodCare Crossmatch Services Manual

 
 
 
 
 

1.1         History
1.2         Mission Statement
1.3         Vision Statement
1.4         Accreditation
1.5         Department Descriptions and Contact Directory
1.6         Forms
                  Bedford Organizational Chart
                  Tyler Organizational Chart


 
 

2.1         Quality Policy Statement
2.2         Quarantine Notices
         2.2.1     Quarantine/Lookback Notices
2.3         Recall/Market Withdrawal Notices
2.4         Quality Assurance Consultation Services
2.5         Forms
                  DPF400.20A Quarantine Request Facsimile
                  DPF400.20B Quarantine Release Request Facsimile
                  QAF403.01 Suspected Component Contamination Notification
                  QAF601.01A Component Recall Market Withdrawal Notification
QAF601.01B Quarantine-Release Notification
                  QAF602.01 Consignee Notification Record
                  QAF602.01.01 Reac Non-Descrim Multiplex HIV-1--HCV Assay Notification
                  RAF601.00 Request for Product Quarantine RADE
                  RTF120.11A Request for Product Quarantine, Discard or Retrieval
                  RTF120.11D Reference & Transfusion Suspected Component Contamination Notification


 
 

3.1         Disaster Plan
         3.1.1    Coordinating the Local Blood Supply During Disasters
                  3.1.1.1     Purpose
                  3.1.1.2     Introduction
         3.1.2     Glossary of Terms
         3.1.3     Carter BloodCare’s Responsibilities
         3.1.4     Customer’s Responsibilities
                  3.1.4.1     Pre-Disaster Preparation Checklist
                  3.1.4.2     During the Disaster
                  3.1.4.3     Working with the Media
         3.1.5     Biological Attack Response Process
         3.1.6     Regulatory Concerns
         3.1.7     Handling Internal Disasters at Carter BloodCare
3.2         Blood Service Agreement Statement
3.3         Finance and Billing Policies
         3.3.1     Third Party Payments
         3.3.2     Payment Options
         3.3.3     Billing Periods
         3.3.4     Payment Terms
         3.3.5     Billing Transaction Document
         3.3.6     Weekly Invoices
         3.3.7     Credit Memo
         3.3.8     Debit Memo
         3.3.9     Return Slip
         3.3.11    Pack List
         3.3.12    Financial Questions
3.4         Notification of Policy Changes
3.5         Forms
                  Credit Memo
                 Debit Memo
                 Pack List
                 Return Slip
                  Weekly Invoice


 
 

4.1   General Customer Complaints, Comments, and Customer Incidents
4.2   Customer Surveys
4.3   Forms
                  QSF702.01;Customer Incident


 
 

5.1         Neighborhood Donor Centers
5.2         Blood Drive Information
5.3         Health Fairs


 
 

6.1         Autologous Donations
         6.1.1   Autologous Blood Donation Request
         6.1.2   Autologous Blood Donation Criteria
         6.1.3   Autologous Donation Scheduling
         6.1.4   Facility Notification of Autologous Donation
         6.1.5   Autologous Labeling
         6.1.6   Low Weight/Volume Autologous Red Cells
         6.1.7   Autologous Unit Testing
         6.1.8   Special Considerations
         6.1.9 Policy for Freezing Autologous Red Blood Cells
6.2         Restricted Donations
6.3         Therapeutic Phlebotomy
         6.3.1   Therapeutic Donor Request
         6.3.2   Therapeutic Donation Criteria
         6.3.3   Therapeutic Phlebotomy Scheduling
         6.3.4   Associated Fee
         6.3.5   Unit Disposition
6.4   Hereditary Hemochromatosis (HH) and Testosterone Replacement Therapy (TRT) Programs
         6.4.1    Donor Meets Eligibility Criteria and has a Draw Frequency of >8 Weeks
         6.4.2    Donor Does not meet Eligibility Criteria &/or Requires a Draw Frequency of <8 weeks
6.5        Forms
         6.5.1    Autologous Forms
                  SDF801.01, Autologous Blood Donation Request
                  SDF8001.01B, Autologous Worksheet
                  SDF801.01C, Donation Attempt Notification Letter to Hospital
                  SDF802.01A, Autologous Blood with Abnormal Test Result Notification
                  SDF801.01E, Frozen Autologous Red Blood Cell – Management Record
                  DCL255, Autologous Tie Tag (double sided)
                  Autologous Donation Information
         6.5.2    Restricted, Therapeutic, HH and LOT Forms
                  DCL500, Restricted Donation tie tag (orange)
                  SDF801.03, Therapeutic Donor Request
                  Therapeutic Donation Information
                  DNF104.35C Enrollment/Prescription for No-Fee Phlebotomy for Hereditary Hemochromatosis (HH) Patients Only
                  DNF104.35D Enrollment/Prescription for Phlebotomy Due to Testosterone Replacement Therapy (TRT)


 
 

7.1        Components Provided
7.2        Component Manipulation Services
7.3        Donor Unit Testing
        7.3.1    Routine Testing
        7.3.2    Other Tests Performed as Indicated
7.4        Testing and Labeling
7.5        Placing an Order
7.6        Specimen Collection and Preparation
7.7        Unacceptable Specimens
7.8        Specimen Shipping
        7.8.1    Sample Shipping Requirements
        7.8.2    Sample Delivery
7.9        Test Turn-Around-Time (TAT)
7.10      Test Cancellation
7.11      Results and Reports
7.12      Forms
                  Acceptable Plasma Example (1)
                  Acceptable Plasma Example (2)
                  HSL200, Carter BloodCare Platelet Apheresis Tag
                  TLF200.00A; Remote Testing Requisition Form
7.13      Acceptable Plasma Examples


 
 

 
 

9.1         General Policies
         9.1.1    Contract
         9.1.2    Sample Shipping Requirements
         9.1.3    Order Deliveries
         9.1.4    Sample Rejection
         9.1.5    Results and Reports
         9.1.6    Crossmatched Product Return Policy
         9.1.7    Test Cancellation
9.2         Test Priority and Turn-Around-Time (TAT)
         9.2.1    Sample Shipping and Delivery TAT
         9.2.2    STAT Order
         9.2.3    ASAP (As Soon As Possible) Order
         9.2.4    Routine Order
         9.2.5    Test Priority Turn-Around-Time Summary Table
9.3         Forms
                  RTF102.03 Immunohematology Final Report
                  RTF102.04 Preliminary Report
                  RTF102.07B Crossmatch Account Report
                  RTF102.07D Crossmatch Account Report (electronic report)
                  RTF104.15 Reference and Transfusion Specimen Rejection Report
              Example Forms
                  DPF-300.03B Request for Pick-up of Units for Return
                  HRDF100.01A Transfusing Facility Medical Director Checklist
                  HRDF100.01B Initial and Annual Storage Checklist


 

10.1         Testing Procedures
         10.1.1  Type and Screen
         10.1.2  Crossmatched Red Blood Cells
         10.1.3  Autologous Red Blood Cells
         10.1.4  Fresh Frozen Plasma, Platelets, or Cryoprecipitate
         10.1.5  Antibody Identification and Antigen Negative Red Blood Cells Components
10.2      Ordering Procedures
         10.2.1  Requisition Completion for Crossmatch Services
         10.2.2  Blood Bank ID Armbands
         10.2.3  Patient Identification
         10.2.4  Blood Sample Collection
         10.2.5  Completion and Delivery
10.3      Blood Administration
         10.3.1  Positive Identification of Intended Recipient
         10.3.2  Compatible IV Solutions
         10.3.3  Blood Warming
         10.3.4  Following Component Infusion
10.4      Adverse Reactions to Transfusions
10.5      Emergency Release of Untested Components
         10.5.1  Compatibility Testing Not Completed
         10.5.2  Infectious Disease Testing Not Completed
10.6      Release of Incompatible Red Cells
10.7      Platelet Testing Services
         10.7.1  Platelet Serology
         10.7.2  HLA Matching
         10.7.3  Platelet Antibody Screening and Crossmatching
         10.7.4  Sample Requirements
         10.7.5  Requisition for Platelet Serological Testing
         10.7.6  Platelet Labeling
10.8      Granulocyte Product Order
10.9      Forms
                  APL100 Crossmatched Apheresis Product Tag
                  APL100 Crossmatch Apheresis Product Tag
                  RTF101.01D Crossmatch Account Services Request Form
                  RTF206.05 Uncrossmatched or Incompatible Product Release
                  RTF214.03 Untested Product Release
                  RTL214.01 Emergency Release Uncrossmatched Blood Label
                  RTL214.03A Previous Donation Results Label
                  RTL214.03B Testing Not Performed Label
                  RTL422.01 HLA Matched Tie Tag
                  Crossmatch Compatibility Tag
                  Non-Crossmatch Compatibility Tag
                  RTL207.01A Confirmed Antigen Typing Label
                  RTL207.01C Molecular Matched Antigen Typing Tag
                  RTF205.13A Granulocyte Product Order & Physician Release Form


 
 

11.1      Reporting Adverse Reactions
      11.1.1.  Definition
      11.1.2.  Types of Adverse Transfusion Reactions
      11.1.3     Transfusion Related Fatalities
      11.1.4     Reporting a Suspected Transfusion Reaction
      11.1.5     Recommended Actions if a Suspected Transfusion Reaction Occurs
      11.1.6     To Initiate a Transfusion Reaction Investigation Work-up
      11.1.7     Carter BloodCare Transfusion Reaction Investigation
11.2      Suspected Cases of Transfusion-Associated Infection
      11.2.1  Notification to Carter BloodCare
      11.2.2  Other Notification
      11.2.3  Carter BloodCare Investigation
11.3      Reporting Transfusion Related Lung Injury (TRALI)
11.4      Forms
                  RTF215.01A Transfusion Reaction Investigation
                  RTF195.03A Transfusion Reaction Investigation Preliminary Report
                  RTF195.03BTransfusion Reaction Investigation Final Report
                  DNF106.02A Report of Suspected Transfusion Associated Infection
                  DNF106.30A Report of Transfusion-Related Acute Lung Injury Investigation
                  DNF106.30D Suspected TRALI Investigation Summary


 
 

12.1         Suggested Services


 
 

13.1      Therapeutic Apheresis Services
13.2      Diseases which may be treated by Apheresis
13.3      Contract/Privileges
13.4      Emergency Privileges
13.5     Granulocyte Orders


 
 

14.1      Overview
14.2      Contract/Privileges
14.3      Emergency Privileges
14.4      Product Collection, Processing, and Infusion
         14.4.1     Collections of Peripheral Blood Stem Cells
         14.4.2     Institutional Responsibilities for PBSC Collection
         14.4.3     Donor Prescreen for PBSC and Marrow Collection
         14.4.4     Assisting with Surgical Harvest of Bone Marrow
         14.4.5     Processing and Cryopreservation
         14.4.6     Product Storage
         14.4.7     Thawing and Infusion
14.5      Forms
                  HPF170.06 Infectious Disease Tube Collection Form


 
 

15.1      Carter BloodCare Tours
15.2      Hospital Forums
15.3      Staff In-services
15.4      External Audits Performed for Transfusion Services
15.5      Known Samples Provided
15.6      Reimbursement Review for Blood Product Coding
15.7      Transfusion Medicine Fellowship Rotation
15.8      Resident Pathologist Blood Center Rotation
15.9      Medical Student Blood Center Community visits